In Real Life, most animals' innards are basically tubes: a mouth at one end, an anus at the other, so food can be processed step by step as it passes from entry to exit. In fiction, it's not uncommon for creatures to omit the latter portion, and double up on the former: they'll have a spare head on the tip of a tail, or symmetrical bodies in which the forequarters of two animals — sometimes of the same species, sometimes different ones — are joined at the waist.

Examples:

Played with the Orochi in Ranma ˝, which has seven small heads on one end and a single, mountainous head on the opposite end.

Several Mykene War Beasts from Mazinger Z and Great Mazinger had a head at each end (an occurrence happened more often than you would think since ALL Mykene War Beasts had several heads: one of them was the Humongous Mecha's head and the other -or others- belonging to the human warrior fused with the mecha). This trope was used for first time in the Mazinger universe in the Mazinger Z vs. Great General of Darkness feature.

Comics

In the comic strips of Cricket, a children's magazine, the earthworm is treated as two characters: its front end, George, and its back end, Tail. The pair of them have different personalities.

Inverted in a Sesame Street comic strip in which Professor Drummond Bugle encountered a reptilian "beast with two tails". As he examined it, he discovered that it had a tail at each end.

One of the less-aggressive animal encounters in The Croods is with the Trip Gerbils, lemur-like creatures joined at either end of a long striped tail.

The Mix-and-Match Critter in Sharktopus has a shark head at one end and a cephalopod's beak embedded among the tentacles at the other.

In Stardust, one of the market stalls has a cage on display containing a miniature elephant with heads at both ends.

Jokes

Two hunters ask their guide to settle a dispute between them as to which animal is the angriest: the lion or the crocodile. The guide answers that it's neither, the angriest animal is the crocolion, a beast that's the front half of a lion and the front half of a crocodile joined in the middle. The hunters protest that this animal can't exist, being unable to poop. The guide answers "Why do you think it's the angriest animal of all?"

An earthworm pops its head out of the ground and sees another earthworm do the same. The first earthworm says "Wow! You're the most beautiful worm I've ever seen! Will you marry me?" And the other earthworm says, "I can't, silly! I'm your other end!"

Literature

In the Doctor Dolittle novels, the Pushmi-Pullyu is an antelope with two front halves, attached at the waist.

In the 1967 film Doctor Dolittle, it's a two-front-ended llama: a creature actually mentioned in Peruvian folklore.

In After Man: A Zoology of the Future, the terratail is a subversion: it has markings on its tail that make it resemble a venomous snake, allowing this small rodent to perform a Backup Bluff, complete with a realistic hiss, when threatened by predatory birds.

The Littralope from Wayne Barlowe's Expedition is a similar subversion, sporting an entire simulated head on its rear end to confuse predators as to which way it's facing. Since the Littralopes, like all the other creatures on the planet, have no eyes or mouths, this ruse is pretty effective.

Some creatures in Greek Mythology, most notably the Chimera, have living, biting snakes for tails.

Depictions of Scylla vary widely, but many portray her with the upper body of a woman (with or without multiple heads) and a lower body consisting of tentacles ending in, or encircled by a row of, dogs' heads.

Another mythological example is the Egyptian Akeru: the front halves of two lions, joined in the middle. Often depicted with a solar disc on each head, it was symbolic of sunrise and sunset.

Some depictions of the Black Tortoise of Chinese constellation depicts the snake what entwines the tortoise coming from where the tortoise's tail is.

Girafarig from the Pokémon games is a giraffe with an extra spherical head as its tail, which bites without warning. In its original design, its heads on both ends were identical.

A whole series of inversions (two bodies joined at a shared cranium) appear in Earthworm Jim, most notably Professor Monkey-for-a-Head.

In a Body Horror style, Thrill Kill has Judas, conjoined twins connected at the waist in such a way that there are heads at each end, two pairs of arms, an no legs. They usually crawl about, but in combat one walks handstand while the other fights.

Twingersnap from Viva Pinata is a snake with a head on each end. It can give rise to Fourheads, which has three heads on one end and one on the other.

In the Facebook game Hatchlings, the hippogriff egg hatches out a creature with a beaked, horse-like head at each end.

In MouseHunt, the Monster Tail mouse from the Polluted series has a toothy maw like a Venus flytrap at the tip of its tail.

Lampshaded in Serious Sam: The Second Encounter upon seeing a statue of such a creature:

Sam: Hmm, they always say two heads are better than one, but how does it fart?

The Duke's Dear Freja from Dark Souls II looks like one huge spider at first, but it's actually two huge spiders conjoined at the rear end. Naturally, each head serves as a weakpoint.

Web Original

In BIONICLE: The Mutran Chronicles, the Makuta are seen solving smaller issues by flipping mutated animals like coins. One time, they flipped one that had two heads and no tail, so it took a while to reach their decision.

In RWBY, the King Taijitu is a giant snake with a head at each end. One head is black and the other is white.

On one of The Simpsons "Treehouse of Horror" episodes, Bart puts Snowball II and Santa's Little Helper through a teleporter and they come out as two different pets: one with both heads, ("Twice the pet with none of the poop!") and one with both butts. ("Eww! You can be Lisa's.")

During the "Pink Elephants on Parade" number in Dumbo, two of the elephants cross through each other and briefly become this.

The pukeme-poopyou, a two-headed goat that continually ejects vomit/diarrhea from either end, filling a pool that the loser of a contest will have to jump into.

In another episode Leela takes Nibbler to the vet and we see a woman with a dog like this. "Remember, Rover gets the pill and Pepper gets the suppository."

At the ceremony where Amy becomes part of Kif's family, they're given a snake to eat that has heads at each end.

An episode of Dragon Tales gives us Meow, the Copy Cat, a literal copycat with two cat heads (one at each end of its body) who had the power to make someone act like another person just by licking their face. The only way to reverse the effects of Meow's spell was to have her lick the affected person a second time.

In Thomas the Tank Engine, Mighty Mac is a Fairlie, a double-ended articulated steam engine. Each end — Mighty and Mac — has a distinct face and identity.

In an odd example, Beast Wars has Quickstrike, a Transformer whose beast mode is a scorpion with a cobra for a tail.

The amphisbaena is a legless lizard whose tail not only looks like its head, but it can also move forwards and backwards. In fact, the only way to tell which end is the head is when it opens its mouth.

Some caterpillars subvert this trope, sporting false eye-spots and other features that make their rear ends look like heads as a decoy for predators.

Likewise, some tropical fish have eyespots on their tails for this reason.

A pair of human Conjoined Twins , known as the "snake twins", were born with two heads on opposite ends of a single long body.

A Native American petroglyph in Utah depicts a bighorn sheep with heads on both ends. Another petroglyph from Tibet portrays a yak with heads on front and back.

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